额叶挫裂伤手术时机的选择与对整体认知功能水平的影响分析

The effects of overall cognitive function of different surgery timing for treating frontal lobe contusion

目的探讨额叶挫裂伤手术时机的选择与对整体认知功能水平的影响。方法 60例额叶挫裂伤患者根据手术治疗时机的不同分为治疗组(30例)与对照组(30例),所有患者首先采用非手术治疗,治疗组同时在入院12～36 h内积极采用手术治疗,对照组在入院后36 h行手术治疗。结果根据GCS评分,治疗组预后良好率为83.3%,对照组预后良好率为50.0%,差异有统计学意义(P<0.05)。治疗组患者术后MMSE、LOTCA评分总分与各分项认知测试分数均显著高于对照组(P<0.05)。治疗组术后的AChE浓度明显低于对照组(P<0.05),而BDNF浓度显著高于对照组(P<0.05)。结论早期手术治疗额叶挫裂伤可提高预后良好率,改善整体认知功能水平,其作用的发挥可能与抑制AChE的表达和促进BDNF的释放有关。

Objective To explore the effects of overall cognitive function of different surgery timing for treating frontal lobe contusion. Methods 60 cases with frontal lobe contusion were divided into the treatment group （30 cases） and the control group （30 cases） according to the timing of surgery, all patients were firstly given non-surgical treatment, and the treatment group were given surgery treatment in 12-36 h after admission, and control group were taken surgery treatment after 36 h. Results According to the GCS score, the treatment group＇s prognosis excellent rate was 83.3%, so that was 50.0% in the control group （P 〈 0.05）. The MMSE, LOTCA total score and each sub-item cognitive test scores of the treatment group af- ter surgey were significantly higher （P 〈 0.05）. The AchE concentration of the treatment group was significantly less than the control group （P 〈 0.05） and the BDNF concentration was significantly higher （P 〈 0.05）. Conclusion Early surgical treatment of frontal contusion can improve the prognosis excellent rate, improve the overall level of cognitive function, it may be related to the inhibition of the AchE expression and the release of BDNF.